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ACUTE STRESS DISORDER VERSUS CHRONIC POSTTRAUMATIC STRESS DISORDER: INHIBITION OF FEAR AS A FUNCTION OF TIME SINCE TRAUMA

Authors

  • Tanja Jovanovic Ph.D.,

    Corresponding author
    • Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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  • Andrea Jambrošić Sakoman M.D.,

    1. Department of Psychiatry, Referral Centre for the Stress Related Disorders of the Ministry of Health of the Republic of Croatia, Regional Center for Psychotrauma, Dubrava University Hospital, Zagreb, Croatia
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  • Dragica Kozarić-Kovačić M.D., Ph.D.,

    1. Department of Psychiatry, Referral Centre for the Stress Related Disorders of the Ministry of Health of the Republic of Croatia, Regional Center for Psychotrauma, Dubrava University Hospital, Zagreb, Croatia
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  • Ana Havelka Meštrović M.A.,

    1. Department of Psychiatry, Referral Centre for the Stress Related Disorders of the Ministry of Health of the Republic of Croatia, Regional Center for Psychotrauma, Dubrava University Hospital, Zagreb, Croatia
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  • Erica J. Duncan M.D.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
    2. Atlanta VA Medical Center, Decatur, GA
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  • Michael Davis Ph.D.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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  • Seth D. Norrholm Ph.D.

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
    2. Atlanta VA Medical Center, Decatur, GA
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  • Contract grant sponsor: NIMH; Contract grant numbers: MH092576 (TJ), MH47840 (MD); Contract grant sponsor: NIDA; Contract grant number: DA018294 (ED); Contract grant sponsor: DoD; Contract grant sponsor: CDMRP; Contract grant number: W81XWH-08-2-0170 (SDN); Contract grant sponsor: NARSAD; Contract grant sponsor: Croatian Ministry of Science, Education, and Sport (DK-K).

Correspondence to: Tanja Jovanovic, Ph.D., Emory University, Department of Psychiatry and Behavioral Sciences, 49 Jesse Hill Jr Dr, Atlanta, GA 30303. E-mail: tjovano@emory.edu

Abstract

Background

Previous work has shown that inhibition of fear is impaired in posttraumatic stress disorder (PTSD) resulting from both civilian and combat trauma. The purpose of the present study was to investigate the inhibition of learned fear in traumatized individuals diagnosed with either acute stress disorder (ASD) or PTSD. This is the first study to use a conditioned inhibition paradigm with traumatized individuals within a month of trauma exposure. We hypothesized that impaired fear inhibition would be evident in PTSD, but not ASD.

Method

Using established translational, psychophysiological methods including fear-potentiated startle, and skin conductance, we examined fear acquisition, stimulus discrimination, and the transfer of learned safety in a Croatian population with ASD or PTSD. This cross-sectional study included three age-matched groups: healthy nontrauma controls (n = 27), a group with chronic PTSD (10 or more years since trauma exposure, n = 24), and a group with ASD (30 days or less since trauma exposure, n = 27).

Results

The presence of trauma-related psychopathology, whether acute or chronic, was associated with an impaired ability to transfer learned safety based on fear-potentiated startle measures, while healthy control subjects showed significant fear inhibition in the presence of the safety cue compared to the danger cue, F(1,26) = 12.64, P = .001.

Conclusions

These data expand our previously observed findings of PTSD-associated fear inhibition deficits by demonstrating that trauma-related impairments in safety learning are evident within 30 days of trauma exposure.

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